{"title":"The promise of digital twins as a tool for personalized approaches in nephrology.","authors":"Reinhard Laubenbacher,Parta Hatamizadeh","doi":"10.1038/s41581-025-01021-5","DOIUrl":"https://doi.org/10.1038/s41581-025-01021-5","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"103 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Somkanya Tungsanga,Ikechi G Okpechi,Maria Eugenia V Bianchi,Swasti Chaturvedi,David Collister,Harley Crowshoe,Giselle M Rodriguez de Sosa,Habibu A Galadanci,Erin Hedin,Kwaifa S Ibrahim,Arsh K Jain,Irene L Noronha,Robin L Erickson,Jaquelyne T Hughes,Paul Komenda,Win Kulvichit,Roberto Pecoits-Filho,Kalani L Raphael,Vallabh O Shah,Malama Tafuna'i,Caroline Tait,Catherine Turner,Curtis Walker,Robert Walker,Cathy Woods,Adeera Levin,Aminu K Bello
{"title":"Global landscape of kidney health across Indigenous populations.","authors":"Somkanya Tungsanga,Ikechi G Okpechi,Maria Eugenia V Bianchi,Swasti Chaturvedi,David Collister,Harley Crowshoe,Giselle M Rodriguez de Sosa,Habibu A Galadanci,Erin Hedin,Kwaifa S Ibrahim,Arsh K Jain,Irene L Noronha,Robin L Erickson,Jaquelyne T Hughes,Paul Komenda,Win Kulvichit,Roberto Pecoits-Filho,Kalani L Raphael,Vallabh O Shah,Malama Tafuna'i,Caroline Tait,Catherine Turner,Curtis Walker,Robert Walker,Cathy Woods,Adeera Levin,Aminu K Bello","doi":"10.1038/s41581-025-01016-2","DOIUrl":"https://doi.org/10.1038/s41581-025-01016-2","url":null,"abstract":"Approximately 480 million individuals worldwide (~6% of the global population) are Indigenous peoples. Despite their diverse cultures and histories, the shared legacy of colonialism has profoundly shaped their health and socioeconomic status. This legacy is deeply intertwined with poverty, systemic racism and historical trauma, contributing to significant health disparities compared with non-Indigenous populations. Among the many chronic diseases disproportionately affecting Indigenous peoples, chronic kidney disease (CKD) stands out as a major public health concern. Indigenous peoples experience higher rates of CKD, yet they often face barriers to accessing responsive and culturally safe health-care services. Factors such as geographic isolation, socioeconomic disadvantages and systemic discrimination limit their access to preventive care, early disease detection and kidney replacement therapy, leading to worse health outcomes and higher mortality rates. Exposure to environmental and occupational risks and inadequate infrastructure further exacerbate CKD risk for Indigenous peoples. Here, we examine determinants of kidney disease and health among major Indigenous populations in Africa, Asia, Australia, Canada, Latin America, Aotearoa-New Zealand, the Pacific Islands and the USA. We discuss culturally safe and responsive strategies that can improve the delivery of kidney care and make policy recommendations for multiple levels of government to ensure health-care systems are equipped to meet the needs of Indigenous communities. By addressing these gaps and promoting cultural competence in kidney care, health-care providers can have a crucial role in reducing health disparities and improving Indigenous peoples' kidney health worldwide.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"86 1 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"20 years of Nature Reviews Nephrology","authors":"","doi":"10.1038/s41581-025-01010-8","DOIUrl":"10.1038/s41581-025-01010-8","url":null,"abstract":"The November 2025 issue of Nature Reviews Nephrology marks the 20th anniversary of the journal. It is a time to reflect on advances in the field and the role of the journal in a time of change.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 11","pages":"717-717"},"PeriodicalIF":39.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41581-025-01010-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glenda V Roberts,Thelma Barber,Nichole M Jefferson,Quenton Turner-Gee,Denay Richards,Robert Sanchez,David Rush,Ololade A Williams,Dinushika Mohottige
{"title":"Harms of terminating NIH grants for kidney disease.","authors":"Glenda V Roberts,Thelma Barber,Nichole M Jefferson,Quenton Turner-Gee,Denay Richards,Robert Sanchez,David Rush,Ololade A Williams,Dinushika Mohottige","doi":"10.1038/s41581-025-01015-3","DOIUrl":"https://doi.org/10.1038/s41581-025-01015-3","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"11 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jurriën Prins,Annabelle Biscans,Anton Jan van Zonneveld,Kendall S Frazier,Eric P van der Veer
{"title":"RNA-based therapeutic opportunities for the treatment of kidney diseases.","authors":"Jurriën Prins,Annabelle Biscans,Anton Jan van Zonneveld,Kendall S Frazier,Eric P van der Veer","doi":"10.1038/s41581-025-01011-7","DOIUrl":"https://doi.org/10.1038/s41581-025-01011-7","url":null,"abstract":"In the past decade, RNA-based therapeutic strategies have transitioned from drugs of promise to transformative treatments for a range of previously untreatable diseases. This transition has largely been driven by a growing comprehension of individual cell types and corresponding transcriptomes in healthy and diseased tissues. However, despite their natural and abundant distribution to the kidney, successful RNA-based therapeutics for kidney diseases are scarce, as the overwhelming majority of administered drugs are either rapidly excreted, localize to non-targeted cells or are unproductive owing to endolysosomal compartmentalization. The limited success in developing RNA-based therapies for this vital organ have led to considerable doubt regarding the targetability and suitability of splice modulation, small interfering or activating RNAs, microRNA mimics or antagonists, aptamers or editing strategies for the treatment of kidney diseases. Strategies to target specific cell types within the kidney and improve the productive uptake of RNA-based drugs are needed to improve the therapeutic efficacy and safety of RNA-based therapies. Despite these challenges, a number of RNA-based therapeutic approaches are being explored for a variety of kidney diseases and hold promise for future validation.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"56 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kumar Sharma,Jens Hansen,Katalin Susztak,Livia Eberlin,Christopher R Anderton,Theodore Alexandrov,Ravi Iyengar
{"title":"Spatial metabolomics and multiomics integration for breakthroughs in precision medicine for kidney disease.","authors":"Kumar Sharma,Jens Hansen,Katalin Susztak,Livia Eberlin,Christopher R Anderton,Theodore Alexandrov,Ravi Iyengar","doi":"10.1038/s41581-025-01007-3","DOIUrl":"https://doi.org/10.1038/s41581-025-01007-3","url":null,"abstract":"Precision medicine is now a feasible prospect for nephrologists as numerous therapeutic options are available for various forms of kidney disease. However, implementation of this strategy will require high-dimensional diagnostic approaches to identify patients who will respond to an intervention and monitor mechanisms of action relevant to the underlying disease process. With the advent of spatial omics, comprehensive and thorough molecular analysis of biological samples is now possible. In particular, spatial metabolomics analysis of kidney biopsy samples could have an important role in facilitating precision medicine for kidney diseases. Spatial metabolomics can be used to monitor changes in the functional outcomes of genes and proteins in specific anatomical compartments such as the glomeruli, tubules, blood vessels and interstitial spaces. Spatial metabolomics studies have identified adenine in regions of interstitial fibrosis and arteriosclerosis in diabetic kidney disease, provided new insights into the regulation of N-glycans in glomeruli from patients with diabetes, and enabled a new metabolomic classification of kidney cancer subtypes. Use of computational informatic platforms to integrate genomics, transcriptomics, proteomics and epigenomics with metabolomics will further enhance the value of spatial metabolomics for clinical applications.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"54 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urine as a source of biomarkers and biological knowledge in chronic kidney disease.","authors":"Antonia Vlahou,Raymond Vanholder","doi":"10.1038/s41581-025-01008-2","DOIUrl":"https://doi.org/10.1038/s41581-025-01008-2","url":null,"abstract":"Albuminuria and estimates of glomerular filtration rate remain the main diagnostic and monitoring metrics used in people with chronic kidney disease (CKD). Although these are both useful markers of kidney disease, they represent the consequence rather than the cause of CKD, can neither detect disease at its earliest stages nor determine its aetiology, and are often suboptimal in guiding therapeutic intervention. By contrast, nucleotide, protein, peptide and metabolite findings from urine can provide a wealth of information about kidney-tissue biology and pathological processes, thereby representing a source of potential biomarkers for early disease detection, prognostication and therapeutic guidance. Urinary biomarker research is currently dominated by studies of protein biomarkers that reflect tissue injury and repair, inflammation and fibrosis, and can be combined for use in multi-marker panels. Data on biomarkers for guiding therapy are scarce, underscoring the urgent need for more targeted studies, given the availability of several new therapies that are effective in attenuating CKD progression and improving patient outcomes. Consequently, although several (mainly protein) biomarkers with evidenced potential to improve disease management are currently available, their clinical implementation is limited by the paucity of clinical and health-economic impact data, especially data on the combined use of urinary biomarkers and the latest therapies available for people with CKD.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"108 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inhibitory effects of oestradiol on ferroptosis may underlie sex differences in AKI","authors":"Ellen F. Carney","doi":"10.1038/s41581-025-01013-5","DOIUrl":"10.1038/s41581-025-01013-5","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 11","pages":"725-725"},"PeriodicalIF":39.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author Correction: Green nephrology: from evidence to action","authors":"Katherine A. Barraclough, Karin G. F. Gerritsen","doi":"10.1038/s41581-025-01014-4","DOIUrl":"10.1038/s41581-025-01014-4","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 11","pages":"809-809"},"PeriodicalIF":39.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41581-025-01014-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}